Potential to Help High-Risk Children and Families Focus of Study

BUFFALO, N.Y. -- Children raised by substance-abusing parents often manifest substantial emotional, behavioral and social problems. Despite this, most parents who enter treatment for substance abuse are very reluctant to allow their children to be involved in treatment or therapy.

To address the problem, researchers at the University at Buffalo's Research Institute on Addictions (RIA) are developing a hybrid treatment method that incorporates training for parents, couples therapy and reduction of substance abuse. The project is being funded by a $2.8 million grant from the National Institute on Drug Abuse to William Fals-Stewart, Ph.D., a senior research scientist at RIA and a research associate professor in the Department of Psychology, UB College of Arts and Sciences.

Fals-Stewart said that 216 married or co-habiting couples, comprised of substance-abusing fathers and nonsubstance-abusing mothers with one or more children, ages 0-12 years, will be recruited for the study. The men will be entering outpatient treatment at community agencies for help with their drug problem.

"We've just finished a study that showed when couples participate in behavioral couples therapy (BCT), their young children display higher psychosocial adjustment in the year after the parents' treatment," Fals-Stewart said, "than children whose parents received other forms of intervention."

The positive effects of couple's treatment -- including reduced substance use, improved communication and reduced partner violence -- appear to lead to improvement in the children's behavior or functioning.

According to Fals-Stewart, "Our findings suggest that BCT has significant effects on the family that extend beyond the couple to their children, even though the children were not actively involved in treatment. In the previous study, parent skills training was not a part of the treatment and parenting issues were not even discussed. We're very hopeful that by including this element, an even stronger statement can be made for a new treatment method."

Secretary of Health and Human Services Tommy Thompson recently called for substance-abuse treatment programs to recognize and deal with the emotional and behavioral problems of children whose

parents seek help for alcoholism or drug abuse. He stated, "We must not allow our children to become the forgotten victims of substance abuse. By providing appropriate services and programs, we have the power to reduce the fear and confusion that they experience and to provide the knowledge and skills that they need to rebound and succeed as they mature into adults."

Intervention programs traditionally face barriers to involving children: approximately two-thirds of fathers seeking substance-abuse treatment and almost half of mothers seeking treatment indicate they are unwilling to have their children participate in individual- or family-based treatment. Some parents may have legal or social service issues, others may not want family issues aired in front of strangers.

In other cases and depending on their age, children may refuse to participate, providers may not be prepared to deal with child-related issues, evening hours for family appointments can be limited or unavailable and billing for these services can be problematic for agencies with funding concerns.

Fals-Stewart's approach would allow child-related issues to be addressed in treatment, without requiring the presence of the child.

As a new treatment targeted at substance-abusing patients and their children, this intervention has the potential for broad and prolonged effects that extend beyond the patients seeking treatment for substance abuse to the children under their care. Such interventions represent an attempt to address a chronic public-health concern. The intervention may prove effective with parents, their high-risk children as they enter adolescence and early adulthood, their children's children and society in general.

The UB investigation is just one step toward long-term clinical study into children's adjustment, fathers' substance use, and family and relationship functioning. Study of provider concerns such as extensive cost, cost-benefit and cost-effectiveness comparisons also will be conducted.

Neil B. McGillicuddy, Ph.D., co-investigator on the research team, is a senior research scientist at RIA and an expert in parental training for families with adolescent substance abusers, interventions for adolescent drug abusers and treatment for partners of addicted persons. Other co-investigators include Francis D. Fincham, Ph.D., SUNY Distinguished Professor in the Department of Psychology, UB College of Arts and Sciences; Brian Yates of American University in Washington, D.C., and Michelle Kelley of Old Dominion University in Norfolk, Va.

Scientists at UB's Research Institute on Addictions have been advancing the knowledge, prevention, and treatment of addictions since 1970.